This application claims priority to U.S. Provisional Application Ser. No. 60/526,700, filed Dec. 2, 2003; and U.S. Provisional Application Ser. No. 60/536,765, filed Jan. 15, 2004. Without limiting the scope of the invention, its background is described with respect to surgical procedures, and in particular, laparoscopy.
Compared with open surgery, laparoscopy results in significantly less pain, faster convalescence and less morbidity. However, eye-hand dissociation, a two-dimensional field-of-view and fixed instrumentation with limited degrees of freedom contribute to a steep learning curve and demanding dexterity requirements for many laparoscopic procedures. One of the main limitations of laparoscopy is the fixed working envelope surrounding each trocar, often necessitating placement of multiple ports to accommodate changes in position of the instruments or laparoscope to improve visibility and efficiency. The placement of additional working ports contributes to post-operative pain and carries a small risk of bleeding or adjacent organ damage. What is needed is a system that reduced the required number of ports.
One such system is disclosed in U.S. Pat. No. 5,352,219, issued to Reddy. A two-part modular tool and method is taught for use in conjunction with laparoscopic techniques by enabling tools to be manipulated within a body cavity through holes created by a shank. The two-part tool has an instrument head initially inserted through a laparoscopic port and an acuminate shaft that intra-corporeally attaches to the instrument head. The instrument head is then manipulated through the needle hole at the site of desired use. The instrument head may be any tool configuration useful in surgical procedures that can be miniaturized to pass through a laparoscopic port. Problem associated with the invention are that the tool has a limited area of use, the tool is limited by the strength and length of the needle and the tool is limited to the site of insertion. The limited two and three dimensional field of view within the body cavity may cause insertion of the needle at the wrong location, requiring additional insertions of the shank, thereby increasing greatly the number of skin punctures and increased morbidity from multiple punctures. Furthermore, in order the manipulate the tool, the needle(s) must not only be of a diameter and strength to make the tool useful, without the benefit of a trocar the tool damages the lining at the site of puncture every time the tool is actuated.